Results 48 papers were identified describing potential influencing features on emergency department visits (n=24 studies) and emergency
admissions (n=22 studies). Patient factors associated with both outcomes were increased age, reduced socioeconomic status,
lower educational attainment, chronic disease and multimorbidity. Features of primary care affecting unscheduled secondary
care were more complex. Being able to see the same healthcare professional reduced unscheduled secondary care. Generally,
better access was associated with reduced unscheduled care in the USA. Proximity to healthcare provision influenced patterns
of use. Evidence relating to quality of care was limited and mixed.

Conclusions The majority of research was from different healthcare systems and limited in the extent to which it can inform policy. However,
there is evidence that continuity of care is associated with reduced emergency department attendance and emergency hospital
admissions.

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